REU Application Form

Personal Information

First Name: Middle Initial: Last Name (family):

Current Contact Information (School Address)

Phone:
Your email:

Permanent Contact Information (Home Address)

Phone:

Educational Information

Your current college/university/institute:
Expected Graduation Date:
Major field of study: GPA (based on A=4.0):
Previous colleges or universities attended:

Academic and career objectives

Honors, awards, recognitions

Research Experience

(Practical experience in research laboratories, academic instructional labs, electronics, computer interfacing, automotive repair, construction, design, etc.)

Research Activities	Location	Dates of Activity

Recent Work Experience

Employer	Location	Dates of Activity

Computer Experience

Please describe your level of computer skills.

REU Goals

Specific area of interest for REU program, if strong preference exists:

NOTE: A participant must be a citizen or a permanent resident of the United States. Clicking the box below certifies that you meet this requirement.
YES, I meet the United States citizen/permanent resident requirement.